- Birmingham, AL
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Health information management (HIM) professionals play a significant role in transitioning from ICD-9-CM to ICD-10-CM/PCS. ICD-10-CM/PCS coding will impact many operational aspects of healthcare facilities, such as physicians'... more
Health information management (HIM) professionals play a significant role in transitioning from ICD-9-CM to ICD-10-CM/PCS. ICD-10-CM/PCS coding will impact many operational aspects of healthcare facilities, such as physicians' documentation in health records, coders' process for review of clinical information, the billing process, and the payers' reimbursement to the healthcare facilities. This article examines the level of readiness and planning for ICD-10-CM/PCS implementation among hospitals in Alabama, identifies training methods/approaches to be used by the hospitals, and discusses the challenges to the ICD-10-CM/PCS coding transition. A 16-question survey was distributed to 116 Alabama hospital HIM directors in December 2011 with follow-up through February 2012. Fifty-three percent of respondent hospitals began the planning process in 2011, and most facilities were halfway or less than halfway to completion of specific implementation tasks. Hospital coders will be or are being trained using in-house training, through seminars/webinars, or by consultants. The impact of ICD-10-CM/PCS implementation can be minimized by training coders in advance, hiring new coders, and adjusting coders' productivity measures. Three major challenges to the transition were identified: the need to interact with physicians and other providers more often to obtain information needed to code in ICD-10-CM/PCS systems, education and training of coders and other ICD-10-CM/PCS users, and dependence on vendors for major technology upgrades for ICD-10-CM/PCS systems. Survey results provide beneficial information for HIM professionals and other users of coded data to assist in establishing sound practice standards for ICD-10-CM/PCS coding implementation. Adequate planning and preparation will be essential to the successful implementation of ICD-10-CM/PCS.
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Health information technology initiatives created the framework for a national health information infrastructure that concomitantly fostered a need to build intellectual capacity within our current and future health information management... more
Health information technology initiatives created the framework for a national health information infrastructure that concomitantly fostered a need to build intellectual capacity within our current and future health information management (HIM) work force. Results from the 2008 HIM Educator Survey are discussed. Developed for voluntary electronic participation, the survey comprised a series of questions about educators' professional interests and responsibilities. Summary data from the 402 respondents are provided and highlight areas such as academic rank, teaching status, salary range, levels of interest in various issues, and use of virtual learning tools. Data from this survey provide insights into the concerns and challenges many HIM educators face in today's training institutions and suggest implications for future directions in work force training and professional development within the HIM field.
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The HIPAA privacy rule (HIPAA) has had both positive and negative effects on the release of patient information by healthcare facilities. Although the intention of HIPAA was to protect patient privacy and to promote security and... more
The HIPAA privacy rule (HIPAA) has had both positive and negative effects on the release of patient information by healthcare facilities. Although the intention of HIPAA was to protect patient privacy and to promote security and confidentiality of patient information, it has had unintended consequences for facilities. To identify some of these unintended effects, two expert panels of health information management directors from healthcare facilities participated in the nominal group technique meetings. They identified 70 barriers related to release of patient information associated with the implementation of HIPAA. The perceived biggest barriers were increases in the public's misunderstanding about release of patient information, lack of an umbrella policy or regulation defining infractions and enforcement that allows individual institutions to make their own interpretations, and challenges to health information management professionals in controlling safeguards related to release of information given the transition to electronic health records and the increased involvement of information technology. The findings from this study suggest there is a need for additional clarification of the regulations governing HIPAA, standardized instructions, and extensive training of healthcare workers.
Research Interests: Business, Information Management, Privacy, Health Care, Access To Information, and 12 moreMedicine, Humans, Enforcement, United States, Pubmed, Unintended Consequences, Article, Confidentiality, Internet privacy, Health facilities, Protected Health Information, and Health Insurance Portability and Accountability Act
Research Interests: Program Evaluation, Informatics, Medical Informatics, Health Informatics, Educational Measurement, and 11 moreMedical Education, Accreditation, Employment, Medicine, Health Information Technology, Curriculum, Analytics, Personnel Selection, Health Information Management, Cooperative Behavior, and Surveys and Questionnaires
Research Interests: General Internal Medicine, Medicine, Emergency Medical Services, Humans, Female, and 14 moreMale, Follow-up studies, Patient Satisfaction, Patient Preference, Clinical Sciences, Aged, Middle Aged, Adult, Telephone, Self report, Continuity of Patient Care, Cross Sectional Studies, Ambulatory Care, and Cohort Studies
Objectives: African Americans (AA) suffer excess hypertension-related health outcomes and their blood pressures (BPs) are widely reported to be less controlled than European Americans (EA). Intensity of hypertension treatment may play a... more
Objectives: African Americans (AA) suffer excess hypertension-related health outcomes and their blood pressures (BPs) are widely reported to be less controlled than European Americans (EA). Intensity of hypertension treatment may play a role. We examined whether AA with treated hypertension received less-intense medication regimens than EA, as reflected in the number of antihypertensive medication classes. Design: Cross-sectional observation of baseline information from the REasons for Geographic And Racial Differences in Stroke cohort. Participants were recruited by telephone in 2003-2005, completed a telephone survey, and had BP measured and medications recorded during an in-home visit. The study's outcome was the number of classes of antihypertensive medications. Setting: U.S. national cohort study with oversampling from high stroke mortality regions. Participants were self-identified AA or EA, > or =45 years old, living in the community, and balanced on AA race and sex by design. Participants: 8960 individuals with treated hypertension. Results: Mean age was 68.0 +/- 8.6 years. AA were poorer and less educated than EA, and had worse BP control (63.5% BP < 140/ 90 mm Hg for AA, 74.0% for EA, P < .01), yet they were on more classes of BP medication (24.1% on > or =3 classes, vs. 16.9%, P < .01). AA were taking an average of 0.138 more antihypertensive medication classes than otherwise similar EA (P < .01). More intense treatment persisted across all age, sex, education, income and BP groups. Conclusions: AA were more intensely treated for hypertension than EA. Further study to identify action strategies to eliminate racial differences in hypertension outcomes is warranted.
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As the use of information technology within the healthcare setting increases, the impact of bridging registry data with electronic health records (EHRs) must be addressed. Current EHR implementation may create benefits as well as... more
As the use of information technology within the healthcare setting increases, the impact of bridging registry data with electronic health records (EHRs) must be addressed. Current EHR implementation may create benefits as well as challenges to cancer registries in areas such as policies and regulations, data quality, reporting, management, staffing, and training. The purpose of this study was to assess 1) the status of EHR usage in cancer registries, 2) the impact of EHR usage on cancer registries, and 3) the benefits and challenges of EHR usage for cancer registries in Alabama. The study method consisted of a voluntary survey provided to participants at the Alabama Cancer Registry Association 2009 annual conference. Forty-three respondents completed the survey. Data indicated that the major benefits of EHR use for the cancer registry included more complete treatment information available to clinicians and researchers, more time for retrieving and analyzing data for clinicians and researchers, and better tracking of patient follow-up. The major challenges included lack of adequate resources, lack of medical staff support, and changing data standards. The conclusion of the study indicates that understanding the impacts and challenges of EHR usage within cancer registries has implications for public health data management, data reporting, and policy issues.
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Moving from paper records to electronic health records (EHRs) has been a challenge for many Alabama hospitals. Implementation of this innovative technology will assist in providing better patient care by allowing for and providing more... more
Moving from paper records to electronic health records (EHRs) has been a challenge for many Alabama hospitals. Implementation of this innovative technology will assist in providing better patient care by allowing for and providing more accurate and available patient information. The purposes of this study were to assess the status of implementation of EHRs among Alabama hospitals;the factors that are associated with EHR implementation; andthe benefits of, barriers to, and risks of EHR implementation.A self-completed survey was mailed to 131 directors in the health information management (HIM) department of Alabama hospitals. Of 91 responding hospitals (69 percent response rate), only 12.0 percent have completed implementation of EHRs. The key factor driving electronic health record (EHR) implementation was to improve clinical processes or workflow efficiency. Lack of adequate funding and resources was the major barrier to EHR implementation. Rural hospitals were less likely to implement EHRs when compared with urban hospitals (p = .07). Adoption of EHRs should be evaluated in depth for hospitals, and particularly for rural hospitals. Ways to seek appropriate funding and provide adequate resources should be explored.
Research Interests: Information Management, IT in healthcare, Data Management, Consumer Behavior, Workflow, and 14 moreMedicine, Health Information Technology, Electronic Health Record, Humans, Pubmed, Diffusion of Innovation, Health Information Management, Hospital Information Systems, Health IT, Patient Care, Alabama, Health Records, Physician and Patient Relationship, and Health Care Surveys
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Research Interests: Engineering, Informatics, Health Informatics, Data Analysis, Analytics, and 2 moreData Science and AHIMA(Data Science and AHIMA)
(Data Science and AHIMA)
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The objective of the study is to identify challenges and associated factors for privacy and security related to telehealth visits during the COVID-19 pandemic. The systematic search strategy used the databases of PubMed, ScienceDirect,... more
The objective of the study is to identify challenges and associated factors for privacy and security related to telehealth visits during the COVID-19 pandemic. The systematic search strategy used the databases of PubMed, ScienceDirect, ProQuest, Embase, CINAHL, and COCHRANE, with the search terms of telehealth/telemedicine, privacy, security, and confidentiality. Reviews included peer-reviewed empirical studies conducted from January 2020 to February 2022. Studies conducted outside of the US, non-empirical, and non-telehealth related were excluded. Eighteen studies were included in the final analysis. Three risk factors associated with privacy and security in telehealth practice included: environmental factors (lack of private space for vulnerable populations, difficulty sharing sensitive health information remotely), technology factors (data security issues, limited access to the internet, and technology), and operational factors (reimbursement, payer denials, technology accessibility, training, and education). Findings from this study can assist governments, policymakers, and healthcare organizations in developing best practices in telehealth privacy and security strategies.
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Telehealth services for patient visits have substantially surged during the COVID-19 pandemic. Thus, there is increased importance and demand for high-quality telehealth clinical documentation. However, little is known about how clinical... more
Telehealth services for patient visits have substantially surged during the COVID-19 pandemic. Thus, there is increased importance and demand for high-quality telehealth clinical documentation. However, little is known about how clinical data documentation is collected and the quality of data items included. This study aimed to identify the current state of and gaps in documentation and develop a best practice strategy for telehealth record documentation. Data were collected from January to February 2021 via a self-designed questionnaire for administrators and managers from physicians' offices and mental health facilities, resulting in 76 valid responses. Survey items included health organization demographic information, use of telehealth policies and procedures, and clinical documentation for telehealth patient visits. Findings from this study can be used to assist government, policymakers, and healthcare organizations in developing best practices in telehealth usage and clinical documentation improvement strategies.
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Data, data everywhere! We are living in the age of “Big Data” and healthcare informatics. The already insurmountable amount of data only continues to grow as organizations strive to meet the data requirements of federal programs such as... more
Data, data everywhere! We are living in the age of “Big Data” and healthcare informatics. The already insurmountable amount of data only continues to grow as organizations strive to meet the data requirements of federal programs such as the “meaningful use” EHR Incentive Program and the Medicare Access and CHIP Reauthorization Act (MACRA), as well as various quality reporting and reimbursement requirements. The need for informaticists will continue to grow—and who better to fill the role than health information management (HIM) professionals
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Data, data everywhere! We are living in the age of “Big Data” and healthcare informatics. The already insurmountable amount of data only continues to grow as organizations strive to meet the data requirements of federal programs such as... more
Data, data everywhere! We are living in the age of “Big Data” and healthcare informatics. The already insurmountable amount of data only continues to grow as organizations strive to meet the data requirements of federal programs such as the “meaningful use” EHR Incentive Program and the Medicare Access and CHIP Reauthorization Act (MACRA), as well as various quality reporting and reimbursement requirements. The need for informaticists will continue to grow—and who better to fill the role than health information management (HIM) professionals
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Research Interests: Obstetrics, Medicine, Self Efficacy, Pregnancy, Humans, and 7 moreFemale, Male, Middle Aged, Adult, Alabama, Southern, and Medical and Health Sciences
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Objectives We aimed to assess the characteristics and health status of a study sample using social media WeChat and to identify the association between social media usage and depressive symptoms among people aged 45 and older in China.... more
Objectives We aimed to assess the characteristics and health status of a study sample using social media WeChat and to identify the association between social media usage and depressive symptoms among people aged 45 and older in China. Methods Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were measured by the 10-item form of the Center for Epidemiologic Studies Depression Scale (CES-D-10). The propensity score matching method (PSM) was performed to balance the characteristics of WeChat users and non-WeChat users. Multilevel logistic regression was used to test the association between the incidence of depressive symptoms and WeChat usage by introducing covariates step by step. Sensitivity analysis was conducted to estimate the robustness of the primary findings. Results A total of 5415 matching cases out of 11,338 total sample were used in this study to generate the final analysis. A multilevel logistic regression model showed t...
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Objectives: The effect of COVID-19 mitigation measures on different oral health care needs is unclear. This study aimed to estimate the effect of COVID-19 mitigation measures on different types of oral health care utilization needs and... more
Objectives: The effect of COVID-19 mitigation measures on different oral health care needs is unclear. This study aimed to estimate the effect of COVID-19 mitigation measures on different types of oral health care utilization needs and explore the heterogeneity of such effects in different countries by using real-time Internet search data.
Methods: Data were obtained from Google Trends and other public databases. The monthly relative search volume (RSV) of the search topics “toothache,” “gingivitis,” “dentures,” “orthodontics,” and “mouth ulcer” from January 2004 to June 2021 was collected for analysis. The RSV value of each topics before and after COVID-19 was the primary outcome, which was estimated by regression discontinuity analysis (RD). The effect bandwidth time after the COVID-19 outbreak was estimated by the data-driven optimal mean square error bandwidth method. Effect heterogeneity of COVID-19 on dental care was also evaluated in different dental care categories and in countries with different human development index (HDI) rankings, dentist densities, and population age structures.
Results: A total of 17,850 monthly RSV from 17 countries were used for analysis. The RD results indicated that advanced dental care was significantly decreased (OR: 0.63, 95% CI: 0.47–0.85) after the COVID-19 outbreak, while emergency dental care toothache was significantly increased (OR: 1.54, 95% CI: 0.99–2.37) 4 months after the COVID-19 outbreak. Compared to the countries with low HDI and low dentist density, the effect was much more evident in countries with high HDI and high dentist density.
Conclusions: COVID-19 mitigation measures have different effects on people with various dental care needs worldwide. Dental care services should be defined into essential care and advanced care according to specific socioeconomic status in different countries. Targeted health strategies should be conducted to satisfy different dental care needs in countries.
Methods: Data were obtained from Google Trends and other public databases. The monthly relative search volume (RSV) of the search topics “toothache,” “gingivitis,” “dentures,” “orthodontics,” and “mouth ulcer” from January 2004 to June 2021 was collected for analysis. The RSV value of each topics before and after COVID-19 was the primary outcome, which was estimated by regression discontinuity analysis (RD). The effect bandwidth time after the COVID-19 outbreak was estimated by the data-driven optimal mean square error bandwidth method. Effect heterogeneity of COVID-19 on dental care was also evaluated in different dental care categories and in countries with different human development index (HDI) rankings, dentist densities, and population age structures.
Results: A total of 17,850 monthly RSV from 17 countries were used for analysis. The RD results indicated that advanced dental care was significantly decreased (OR: 0.63, 95% CI: 0.47–0.85) after the COVID-19 outbreak, while emergency dental care toothache was significantly increased (OR: 1.54, 95% CI: 0.99–2.37) 4 months after the COVID-19 outbreak. Compared to the countries with low HDI and low dentist density, the effect was much more evident in countries with high HDI and high dentist density.
Conclusions: COVID-19 mitigation measures have different effects on people with various dental care needs worldwide. Dental care services should be defined into essential care and advanced care according to specific socioeconomic status in different countries. Targeted health strategies should be conducted to satisfy different dental care needs in countries.
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To evaluate potential associations among condom errors and gonorrhea and chlamydial infection among a population of sexually transmitted disease clinic patients. Audio computer-assisted self-interviewing was used to conduct a... more
To evaluate potential associations among condom errors and gonorrhea and chlamydial infection among a population of sexually transmitted disease clinic patients. Audio computer-assisted self-interviewing was used to conduct a cross-sectional survey with 1124 participants. Biological specimens were collected during the evaluation visit. A substantial proportion of participants reported condom-use errors with condom breakage statistically associated with gonorrhea infection among males at enrollment (AOR = 1.91; 95% CI: 123-2.96; P = .004). Behavioral interventions that promote consistent condom use must provide the necessary skills associated with proper condom use.
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Abstract Introduction: Alcohol abuse is of epidemic proportions in Ukraine, including the Vinnitsya Oblast (county), a midsized urban area in central Ukraine. Care for persons with alcohol disorders, provided in regional narcologic... more
Abstract Introduction: Alcohol abuse is of epidemic proportions in Ukraine, including the Vinnitsya Oblast (county), a midsized urban area in central Ukraine. Care for persons with alcohol disorders, provided in regional narcologic dispensaries, consists primarily of ...
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Northeast Alabama Regional Medical Center (RMC) in Anniston, Alabama purchased a smaller hospital in 2017. Staff at the two hospitals were tasked with merging the two Electronic Medical Record (EMR) systems into one unified system. From... more
Northeast Alabama Regional Medical Center (RMC) in Anniston, Alabama purchased a smaller hospital in 2017. Staff at the two hospitals were tasked with merging the two Electronic Medical Record (EMR) systems into one unified system. From the outset, there were two systems with different medical record number specifications and patient identification systems as well as two different patient name parameters. The merging of these records and systems meant dealing with different vendor EMR systems and ancillary systems to produce a single unified record within RMC's EMR and the document imaging system that housed the legal medical record for each patient. This case study describes the process and procedures of merging the patient records from both hospitals to create one Enterprise Master Patient Index (EMPI); and the collaboration between the Health Information Management and Information Technology departments to accomplish this goal. It also reviews the impact and challenges relate...
Research Interests: Medicine()
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Research Interests: Medicine()
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The HIPAA privacy rule (HIPAA) has had both positive and negative effects on the release of patient information by healthcare facilities. Although the intention of HIPAA was to protect patient privacy and to promote security and... more
The HIPAA privacy rule (HIPAA) has had both positive and negative effects on the release of patient information by healthcare facilities. Although the intention of HIPAA was to protect patient privacy and to promote security and confidentiality of patient information, it has had unintended consequences for facilities. To identify some of these unintended effects, two expert panels of health information management directors from healthcare facilities participated in the nominal group technique meetings. They identified 70 barriers related to release of patient information associated with the implementation of HIPAA. The perceived biggest barriers were increases in the public's misunderstanding about release of patient information, lack of an umbrella policy or regulation defining infractions and enforcement that allows individual institutions to make their own interpretations, and challenges to health information management professionals in controlling safeguards related to relea...
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Bioterrorism/natural disaster events add significant specialized demands and disrupt normal operation of the health system, often for an indefinite period of time. Health administration leaders should be educationally prepared for and... more
Bioterrorism/natural disaster events add significant specialized demands and disrupt normal operation of the health system, often for an indefinite period of time. Health administration leaders should be educationally prepared for and informed about these potential events, but few receive this knowledge via their academic preparation in health administration. This study examined the existence of coverage of bioterrorism topics in health administration curricula and characteristics of bioterrorism coverage in current health administration programs through a self-completed survey among AUPHA graduate and undergraduate program members. Of the total survey respondents, only 32% of programs have current coverage of bioterrorism. The main reasons for nothavingbioterrorism coverage were not having enough resources; not having enough time to develop course/materials; and not thinking it is necessary to add these courses/materials. To prepare better and to inform future health administrators...
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BACKGROUND Hospital cancer registry data are used for a variety of aspects of patient care, yet one of the lesser used purposes of cancer registry data is to improve care coordination. OBJECTIVES The purposes of this study were to assess... more
BACKGROUND Hospital cancer registry data are used for a variety of aspects of patient care, yet one of the lesser used purposes of cancer registry data is to improve care coordination. OBJECTIVES The purposes of this study were to assess hospital cancer registrars' perceptions of (1) the use of and quality of hospital cancer registry data for care coordination and other purposes; (2) the availability of all needed data for complete hospital cancer registry data collection; and (3) the data collection of COVID-19 effects on cancer patients. METHODS A survey was sent to hospital-based members of Cancer Registrars of Illinois between April and June 2020. Survey questions focused on current use and quality of hospital cancer registry data for care coordination as well as items related to COVID-19's effect on cancer patients. The focus of this study was hospital-based registrars, as they are the individuals collecting data directly from primary patient records. RESULTS While hosp...
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As the use of information technology within the healthcare setting increases, the impact of bridging registry data with electronic health records (EHRs) must be addressed. Current EHR implementation may create benefits as well as... more
As the use of information technology within the healthcare setting increases, the impact of bridging registry data with electronic health records (EHRs) must be addressed. Current EHR implementation may create benefits as well as challenges to cancer registries in areas such as policies and regulations, data quality, reporting, management, staffing, and training. The purpose of this study was to assess 1) the status of EHR usage in cancer registries, 2) the impact of EHR usage on cancer registries, and 3) the benefits and challenges of EHR usage for cancer registries in Alabama. The study method consisted of a voluntary survey provided to participants at the Alabama Cancer Registry Association 2009 annual conference. Forty-three respondents completed the survey. Data indicated that the major benefits of EHR use for the cancer registry included more complete treatment information available to clinicians and researchers, more time for retrieving and analyzing data for clinicians and r...